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MA•02670-01 (Rev 7 STATE OF MINNESOTA (Rev 4) DEPARTMENT ?` NATURAL RESOURCES NOTIFICATION OF PERMIT APPLICATION INSTRUCTIONS FOR THE APPLICANT Miaweaota Statutes, Section 10S.44, Subdivision 1, requires you to supply a complete copy asd all supporting data of your water permit application to the following: A) The chief executive officer of the city or township within which the project is located. B) The secretary of the Board of Managers of the watershed district, if any, within which your project is located or which your project may affect. You MIST certify having served the complete applicd «on on the above in the box on the back side othe application form M-S4. IN ADDITION, if your project is NOT located in a city, a complete copy and all supporting data of the application should be submitted to the Administrator of the Shoreland Manage- ment Program for the affected county. Complete this fors for each notice served on a local government official. SECTION I (TO BE CONP=D BY APPL_ _ANT) TO: A) C,.h�i ,cAccutive officer of the (sham Ly, city, Q township of v)la0 print or t1rpe roans B) Secretary of the board of managers of the a 44 watershed district. print or type none C) Administrator of the Shoreland management program of (K! /*-- county. prr.nt of@ type none FROM: �C Date: C t 19 Tint or Atype ee of app ieant INSTRUCTIONS FOR THE LOCAL GOVERNMENT This report from provides you an opportunity to submit input to the Department of Natural Resources to assist in deciding whether to grant, modify, or deny the requested pen,lit. It is NOT absolutely necessary for local agencies to officially approve or disapprove the project or make any recommendation, although this may be done if desired. It is requested that local agencies indicate the following, as applicable: A. The relationship of the proposed project to local plans for the affected water and related land. B. The relationship of the project to local land use controls including flood plain and/or shoreland regulations. (continued -)r reverse aide;